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扩大左侧大肠切除术后恢复肠道连续性:对逆窗和德洛耶尔技术进行比较研究

Lukas Schabl¹, Lucas F Sobrado², Imran Khan³

¹Department of Colon and Rectal Surgery, Cleveland Clinic, Cleveland, OH, United States; Department of General, Visceral and Thoracic Surgery, University Hospital Salzburg, Salzburg, Austria.

Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract

|November 19, 2025

概括

逆窗技术 (RIWT) 和德洛耶尔技术 (DT) 对于扩展的左切除术解剖体是安全的. 这两种手术方法都显示出相似的结果,技术选择取决于外科医生的专业知识和手术内发现.

科学领域:

结肠直肠手术结肠直肠手术
手术瘤学手术瘤学
胃肠道手术胃肠道手术

背景情况:

扩展的左半球切除术可能会导致在建立结肠异位症方面存在挑战,因为没有足够的范围.
德洛耶斯技术 (DT) 和逆窗技术 (RIWT) 是重建的主要外科选择.
对比DT和RIWT的安全性和功能结果对于患者管理至关重要.

研究的目的:

为了比较Deloyers技术 (DT) 和逆窗技术 (RIWT) 的安全性和功能性结果,用于扩展左半球切除术后的解剖.
为了评估每种技术后的术后生活质量 (QoL) 和肠道功能.

主要方法:

从成年患者 (1995-2023) 收集的前性数据的回顾性队列分析.
纳入标准:在第三级中心接受RIWT或DT的患者.
评估的主要结果:并发症,患者报告的肠功能和使用验证问卷的QoL.

主要成果:

在87名患者中进行RIWT;在97名患者中进行DT,癌症是两者最常见的指示.
在索引手术期间,RIWT的频率更高 (64.4%与33.0%相比),而DT的低解 (57.7%与27.6%) 和保护性口腔 (69.1%与19.5%) 的频率更高.
在RIWT中,术后骨的几率较高 (OR,7.2),但整体并发症率 (Clavien-Dindo等级>II) 和QoL/禁欲得分在各组之间是可比的.

结论:

无论是RIWT还是DT都是安全有效的,用于延长左切除术后的无张力解剖.
这两种技术之间的并发症率和功能结果是相似的.
手术技术的选择应以手术期间的条件和外科医生的专业知识为指导.

关键词:

肠道的连续性肠道的连续性德洛耶尔的技术德洛耶尔的技术扩展左侧大肠切除术功能性结果的结果.复古的窗户技术复古的窗户技术

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